Anal fissure s pile posteriorly

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Chronic anal fissure: 2% topical diltiazem hydrochloride

Anal Fissure Expanded Information | ASCRS

Author disclosure: Richard L. Nelson has received fees from the American College of Physicians for web-based education modules. He is also the author of references cited in this review. Chronic anal fissures typically occur in the midline, with visible sphincter fibers at the fissure base, anal papillae, sentinel piles, and indurated margins.

Anal fissures

Anal fissure fissure-in-ano is a very common anorectal condition. The exact etiology of this condition is debated; however, there is a clear association with elevated internal anal sphincter pressures. Though hard bowel movements are implicated in fissure etiology, they are not universally present in patients with anal fissures. Half of all patients with fissures heal with nonoperative management such as high fiber diet, sitz baths, and pharmacological agents.

An anal fissure is a longitudinal tear of the perianal skin distal to the dentate line , often due to increased anal sphincter tone. Anal fissures are classified according to etiology e. They are typically very painful and may present with bright red blood per rectum hematochezia. Anal fissures are a clinical diagnosis based on history and examination findings. Management is primarily conservative, and includes stool softeners, analgesia , and possible local muscle relaxation; because of the risk of incontinence, surgical intervention is a last resort.